BackgroundIn each society, the health of women in different periods may be endangered by an unequal distribution of resources, facilities, and gender prejudices. The present study evaluated the time trend of Iranian women’s health between 1990 and 2013.MethodsThis narrative review includes an integration and descriptive summary of the existing evidence on trends and criteria of different aspects of women’s health from social determinant point of view. The evidence was drawn from peer-reviewed, cross-national or large-scale studies, official sources of the Ministry of Health, reviews, and online scientific databases published between 1990 and 2013.ResultsThe average life expectancy of Iranian women has increased from 44.15 years in 1960 to 75.75 years in 2012; in most deprived provinces of Iran, however, this criterion is about 67.3 years, and in the capital it is 75.8 years. In 2011, 43.37 % of DALYS, 36.21 % of YLL, and 1.92 % of YLD were dedicated to women; these figures were 3.63 % lower than they were in 2003. Although a significant reduction has occurred in maternal mortality rate, which dropped from 83 to 23 per 100,000 between 1990 and 2013, there is no equal distribution in maternal mortality across the country as manifested by the unfavorable conditions of border provinces (SD = 19.2). The prevalence of HIV/AIDS is an alarming health problem among Iranian females, increasing approximately 546 % between 2007 and 2015. As for mental health, depression in women was ranked first among diseases in 2011 compared to a second place ranking in 2003. As regards social health, the delinquency of women has increased in recent years compared to men with women committing more crimes related to drugs and actions against virtue. The annual report of the United Nations for the gender gap index in 2013 ranked Iran as 130 among 136 countries (from 0.622 in 2000 to 0.584 in 2013).ConclusionGenerally, over the last three decades, the health indices of Iranian women have grown in aspects of physical, mental, and social health. Remarkable differences can be seen among female health indices based on geographic location and in comparison with men. To promote an improved health status for Iranian women, the root causes of the discrepancies must be identified and a comprehensive national plan must be established.
Background: Understanding the prevalence of symptoms associated with sexually transmitted infections (STIs) and how care is sought for those symptoms are important components of STIs control and prevention. People's preference between public and private service providers is another important part of developing a well-functioning STIs surveillance system. Methods: This cross-sectional survey was carried out in spring 2011, using a nonrandom quota sample of 1190 participants (52% female) in 4 densely-populated cities of Tehran, Kerman, Shiraz, and Babol. Two predictive logistic regression models were constructed to assess the association between the socio-demographic determinants (independent variables) and the dependent variables of history of STIs-associated symptom and seeking care. Results: Around 57% (677 out of 1190; men: 29.70% and women: 81.80%) had experienced at least one STIsassociated symptom during the previous year. History of experiencing STIs-associated symptoms among men, was negatively significantly associated with older age (adjusted odds ratio [AOR] = 0.34, CI 95%: 0.17-0.67). Women who were married, in older ages, and had higher educations were more likely to report a recent (past year) STIs symptom, however all were statistically insignificant in both bivariate and multivariable models. Among those who have had STIs-associated symptoms in the last year, 31.15% did nothing to improve their symptoms, 8.03% attempted self-treatment by over-the-counter (OTC) medications or traditional remedies, and 60.93% sought care in health facilities. In both bivariate and multivariable analyses, care seeking among men was insignificantly associated with any of the collected demographic variables. Care seeking among women was positively significantly associated with being married (AOR = 2.48, 95% CI: 1.60-3.84). Conclusion:The reported prevalence of STIs-associated symptoms among our participants is concerning. A considerable number of participants had delayed seeking care and treatment or self-medicated. People should be informed about their sexual health and the consequences of delaying or avoiding seeking care for STIs. Participants preferred seeking care at private sectors which calls for engaging both public and private health sectors for reporting and following up STIs cases. Implications for policy makers• Unfolding these patterns of care seeking for sexually transmitted infections-associated (STIs-associated) symptoms among the general population can help policy-makers improve the quality of STIs care and treatment and provide a better provision over STIs services. • Policy-makers should prioritize establishment of a sentinel-based STIs case reporting system. • STIs prevalence assessment surveys among the general population would be a valuable asset in monitoring the trend of STIs across the country.• Policy-makers should monitor the pharmacies effectively and force them to stop selling non-prescribed antibiotics for STIs treatment. •The considerable prevalence of STIs-associated symptoms co...
BackgroundRoad traffic accident (RTA) is one of the main causes of trauma and known as a growing public health concern worldwide, especially in developing countries. Assessing the trend of fatalities in the past years and forecasting it enables us to make the appropriate planning for prevention and control.ObjectivesThis study aimed to assess the trend of RTAs and forecast it in the next years by using time series modeling.Materials and MethodsIn this historical analytical study, the RTA mortalities in Zanjan Province, Iran, were evaluated during 2007 - 2013. The time series analyses including Box-Jenkins models were used to assess the trend of accident fatalities in previous years and forecast it for the next 4 years.ResultsThe mean age of the victims was 37.22 years (SD = 20.01). From a total of 2571 deaths, 77.5% (n = 1992) were males and 22.5% (n = 579) were females. The study models showed a descending trend of fatalities in the study years. The SARIMA (1, 1, 3) (0, 1, 0) 12 model was recognized as a best fit model in forecasting the trend of fatalities. Forecasting model also showed a descending trend of traffic accident mortalities in the next 4 years.ConclusionsThere was a decreasing trend in the study and the future years. It seems that implementation of some interventions in the recent decade has had a positive effect on the decline of RTA fatalities. Nevertheless, there is still a need to pay more attention in order to prevent the occurrence and the mortalities related to traffic accidents.
Background:Clinical outcome in patients with severe traumatic brain injury (TBI) depends on both primary and secondary brain injuries. Neuroinflammation is an important secondary mechanism, which occurs by releasing interleukins (ILs). Increased levels of ILs may affect clinical outcome following TBI.Objectives:This study aimed to determine the relationship between the serum levels of interleukins 6, 8 and 10 and clinical outcome in patients with severe TBI 6 months after injury.Patients and Methods:In a descriptive-analytical study, 44 patients with GCS ≤ 8 (Glasgow coma scale) and age ≥ 14 years were included. Their blood samples were collected at first 6 hours after injury. Clinical outcome was determined based on GOS (Glasgow Outcome Scale) at 6 months after head injury. Serum levels of interleukins 6, 8 and 10 were measured using the ELISA method. Spearman's rho, independent T-Test, and Mann-Whitney Test were used for data analysis.Results:Comparing the serum levels of interleukins in two groups with favorable and unfavorable clinical outcomes showed that the mean serum levels of interleukins 6 and 8 in group with favorable outcome was 85.2 ± 51.6 and 52.2 ± 31.9, respectively lower than those of group with unfavorable outcome with 162.3 ± 141.1 and 173.6 ± 257.3 (P < 0.03) and (P < 0.01).Conclusions:Increased serum levels of interleukins 6 and 8 as a predictive marker might be associated with unfavorable clinical outcome in patients with severe TBI.
PurposePediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergent surgery. The objective of this study was to determine the predictive values of injury severity score (ISS), new injury severity score (NISS) and revised trauma score (RTS) on children's mortality, hospitalization and need for surgery.MethodsIn this study, records of trauma patients under 15 years old transported from a trauma scene to emergency department of Poursina hospital from 2010 to 2011 were included. Statistical analysis was applied to determine the ISS, NISS and RTS ability in predicting the outcomes of interest.ResultsThere were 588 records in hospital registry system. The mean age of the patients was (7.3 ± 3.8) years, and 62.1% (n = 365) of patients were male. RTS was the more ability score to predict mortality with an area under curve (AUC) of 0.99 (95% CI, 0.99–1). In the hospital length of stay (LOS), ISS was best predictor for both the hospital LOS with AUC of 0.72 (95% CI, 0.67–0.76) and need for surgical surgery with AUC of 0.94 (95% CI, 0.90–0.98).ConclusionRTS as a physiological scoring system has a higher predicting AUC value in predicting mortality. The anatomic scoring systems of ISS and NISS have good performance in predicting of hospital LOS and need for surgery outcomes.
Background:Road traffic accidents and their related deaths have become a major concern, particularly in developing countries. Iran has adopted a series of policies and interventions to control the high number of accidents occurring over the past few years. In this study we used a time series model to understand the trend of accidents, and ascertain the viability of applying ARIMA models on data from Taybad city. Methods: This study is a cross-sectional study. We used data from accidents occurring in Taybad between 2007 and 2011. We obtained the data from the Ministry of Health (MOH) and used the time series method with a time lag of one month. After plotting the trend, non-stationary data in mean and variance were removed using Box-Cox transformation and a differencing method respectively. The ACF and PACF plots were used to control the stationary situation. Results: The traffic accidents in our study had an increasing trend over the five years of study. Based on ACF and PACF plots gained after applying Box-Cox transformation and differencing, data did not fit to a time series model. Therefore, neither ARIMA model nor seasonality were observed. Conclusion: Traffic accidents in Taybad have an upward trend. In addition, we expected either the AR model, MA model or ARIMA model to have a seasonal trend, yet this was not observed in this analysis. Several reasons may have contributed to this situation, such as uncertainty of the quality of data, weather changes, and behavioural factors that are not taken into account by time series analysis.
Bell's palsy is a rare complication reported after COVID-19 vaccination. Given the importance of neurological manifestations, the necessity to highlight and scrutinize the incidence of them following vaccination is needed.
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